Doula FAQ's
What are the benefits of having a doula?
Women cared for during labor by a birth doula, compared to those receiving usual care were:
•Reduced the overall cesarean rate by 50%
•Reduced the length of labor by 25%
•Reduced oxytocin use by 40%
•Reduced the use of pain medication by 30%
•Reduced forceps deliveries by 40%
•Reduced requests for epidural pain medication by 60%
•Reduced incidences of maternal fever
•Reduced the number of days newborns spent in NICU (neo-natal infant care unit)
•Reduced the amount of septic workups performed on newborns
•Resulted in higher rates of breastfeeding
•Resulted in more positive maternal assessments of maternal confidence
•Resulted in more positive maternal assessments of maternal and newborn health
•Resulted in decreased rates of postpartum depression

Doula and Childbirth Services
Are doula services covered by insurance?
Although the care that doulas provide is non-medical, it does have medical and financial benefits. Many hospitals are recognizing that factor and some insurance companies are beginning to reimburse parents for doula services. Medicaid funds are sometimes allocated for doula services by some county agencies and private foundations have also provided grants to cover the cost of doula care.
Third-Party Billing for Birth Professionals-Your insurance company may cover a portion of the cost for a labor professional.  For doula services, you will receive a billing statement from me that you may copy and send with a claim to your insurance company. I cannot guarantee that any costs will be covered, however, I encourage you to check with your insurance provider.
Other Options:
Parents in the United States may have a flex-spending account in which a percentage of their wages are placed in a pre-tax account that can be used for non-covered medical expenses. Hospitals and individual physicians who directly employ doulas may also bill for doula services.
If you are feel that doula services are too much for your family, please ask me about your options.


When and how do I pay for doula services?
A deposit is required when a contract is signed at your first visit.  The amount is determined by a sliding scale based on your family's income.The amount can be made in full at contract signing or you may make payments up to two weeks prior to due date.  Every woman deserves a positive birth experience and every baby deserves a good beginning.  Cost is the same for cesarean births.

Does a doula replace a birth partner?
A doula does not replace your birth partner.  A doula is available at the birth to interact with your team, whomever you choose to accompany you during childbirth.  A doula will help relieve fears in your birth partner to give them confidence in their assistance to your needs.  A doula also remains by the mother during the entire labor, which allows the partner to take needed breaks.  A doula remains focused on the mother's needs the entire time, where the birth partner can also look after baby once they are born.

Would I need a doula for a cesarean birth?
A doula can bring in another set of hands and eyes and ears to help you better prepare for your upcoming surgical birth. She can help you get answers to your questions and formulate a birth plan for a cesarean section. Sometimes your doula can even help you by offering you an educational class on cesarean section.
During the pre-operative period, your doula can help explain procedures to you and help you get answers to any questions that you have, much like she would during a normal labor setting. Your doula can help you manage painful procedures like the administration of an IV, or even the spinal or epidural anesthesia for your surgery.
Once inside the operating room, your doula will assist you in knowing what is going on by giving you details of whatever you wish to know. Your surgeon and assistants are busy doing the surgery. The nurses are preparing the room for the baby. Your husband is awaiting the baby and will soon go to the warmer to greet the baby. Your doula will be at your side. She can take photos if you desire, particularly after the baby is born. She can remind the staff of any special requests you may have, like letting your husband announce the gender of the baby or a quiet room during the birth.
If your baby needs to go to the nursery, your husband can go with the baby. Your doula stays by your side. She can also act as a liaison between the staff and you for getting updates on baby while you are separated.
One important fact to remember about the cesarean is that the baby is born in the first few minutes. The rest of the nearly hour long procedure is the repair. If your husband is busy with the baby or in the nursery, you would otherwise be alone during this period. During the postpartum period your doula can suggest post-operative comfort measures. She can assist you with any breastfeeding questions you may have or special help you or baby may require with breastfeeding. Your doula can also help with reminding the staff about your birth plan and special needs you may have.

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What is the average cost for doula services?
Costs are based on family income with a sliding scale, however the cost is usually between $300-$700.  The average cost is $500. 

When does the birth doula arrive once I am in labor?
Once you are in labor, you may contact your doula.  She will either meet you at your home, birth center, or hospital.  After contacting her, she will try to be there 30-60 minutes after you call.

Do doulas only assist women who want a natural birth?
No, doulas are there for emotional and physical support for any woman giving birth, whether it be a natural-unassisted birth, medicated birth, or cesarean birth. Whether you are giving birth in your home, a birthing center, or hospital, I am there to assist you and your needs.

Can a doula perform medical exams?
No, doulas do not perform any medical support.  We are available for the comfort and support for the birthing mother.

Will my doula help me make decisions about my choices during childbirth?
A doula is specifically trained to be able to offer you knowledge about procedures and their risks and benefits, however a doula will not offer you her opinion.  Doulas offer information to you so that you can make an informed decision.

How does a doula work with the hospital staff?
Doulas do not take the place of your healthcare team. A doula helps to meet the emotional and physical needs of the mother.  Doulas do not perform any medical procedures.  Although nurses are available, they are not able to perform the constant support to the mother as a doula can.  A doula acts as a liaison with the medical staff, but does not make decisions for the mother.  Staff members are available to care for the baby's needs, doulas are available strictly to care for the mother.

How does the birth doula help after my baby is born?
A birth doula stays with the mother 1-2 hours after delivery to help with breastfeeding and to make sure that mother's needs are met.  A doula schedules 1-2 postpartum visits to make sure mom and baby are doing well with breastfeeding and that mom has what she needs to begin her journey with her new addition. 
Tina provides 24 hour on-call service up to 2 weeks postpartum for any questions that mom has about breastfeeding and other concerns.

What if I need a postpartum doula?
Tina is trained as a birth doula, however postpartum doulas are available to help with the care of mother's needs after the birth of their baby.
If you need a postpartum doula, please visit www.childbirthinternational.com and click on find a doula.  Although there aren't any listed in the Longview/Kelso area, there are doulas from other locations that may be able to travel to your home.

What if I am still not sure if doula services are right for my family?
If you have reviewed my website and still are not sure if doula services are right for you and your family, please contact me and we will schedule a free consultation where you can ask me questions or voice your concerns.  I want you to feel free to ask me and interview me.  If you would like information on a particular subject, I would be welcome to bring along information that will help you to decide what is best for you.

What if I don't decide I want doula services until I am in labor?
Unfortunately, I cannot guarantee I can assist you at such late notice, but I do know other doulas who may be of assistance if I am unavailable, but no guarantees can be made.  Also, you would still be required to pay the full amount based on your family's income, before services are provided, as well as sign the appropriate contract.  This means that you will need to have a check ready. 

What if my doula is not available when I go into labor?
Although I would like to think that I would never miss a birth, I have a fellow doula available for back-up in the case I am unavailable due to illness or other circumstances.  If you decide to use the back-up doula, I will call her for you. I will then transfer all fees to the attending doula, minus the cost for services already provided prenatally and those for the postnatal visits.

Doula and Childbirth Services, LLC